Comparable reduction of the visceral adipose tissue depot after a diet-induced weight loss with or without aerobic exercise in obese subjects: a 12-week randomized intervention study

Objective: Weight loss with preferential effect on the visceral adipose tissue (VAT) depot could have important clinical benefits. In this study, we investigated the independent and combined effect of regular exercise and diet induced weight loss on body fat distribution. Design: Randomized control design of i) exercise-only (EXO: 12 weeks of exercise without diet-restriction), ii) hypocaloric-diet (DIO; 8 weeks of very low energy diet (VLED 600 kcal/day) followed by 4-weeks weight maintenance diet) and iii) hypocaloric-diet and exercise (DEX: 8 weeks VLED 800 kcal/day+a 4-week weight maintenance diet combined with exercise throughout the 1.2 weeks). Subjects: Seventy-nine obese males and females were included. Measurements: Body fat distribution was quantified by magnetic resonance imaging (MRI)-technology. Results: In the EXO group, the weight loss (3.5 kg) and the relative reduction in VAT (18%,) was significantly lower compared with the weight losses in the NO and DEX groups (12.3 kg; P<0.01) and to the reduction in VAT (30-37%; P<0.01.). In all the three groups, the relative reduction of VAT was higher as compared with the reduction in fat mass (FM: combining all fat depots determined by MRI: P<0.01 for all comparisons). The changes in VAT were associated with changes in FM and related to the initial VAT/FM ratio (r(2) =0.72: P<0.01). Conclusion: Exercise has no additional effects in reduction of the VAT depot. compared with the major effects of hypocaloric diet alone. In addition, the effects of exercise per se on VAT are relatively limited. The effects on the VAT depot are closely associated with changes in total FM.